Research Topic White Paper #1

Institute for Research on

Unlimited Love
Altruism, Compassion, Service

HUMAN DEVELOPMENT AND UNLIMITED LOVE

Gregory Fricchione MD
Director of the Mental Health Program
The Carter Center
Associate Professor of Psychiatry
Harvard Medical School
Brigham and Women’s Hospital

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I. Introduction: Topic Area Description

This research area will focus on the analyzing and synthesizing of biological,
psychological, sociological, spiritual and religious aspects of the human developmental
trajectory that may serve to foster unlimited love and altruism. At the outset we must
stipulate the assumption inherent in this treatment of unlimited love and genuine altruism;
namely that the human has the capacity to give unlimited love in a genuinely altruistic
way. This stands in contrast to the thought of some theologians who believe that
unlimited or agapic love is outside man’s capabilities and comes into the world only as a
gift to the blessed among us from God in an all or nothing fashion. The Human
Development approach on the other hand would contend that, while it is true that God
may be the source of all love, the human capacity to give it to others is a continuous
variable. It is a capacity that can be fostered, enhanced and nurtured or conversely
undermined or even destroyed in the course of an individual’s biopsychosociospiritual
hermeneutics.
Human development as an area of inquiry is probably the broadest topic to be
studied in the IRUL. A full and deep treatment of it will require forays into the
evolutionary biology of the brain, the neuroscience of development and the
endocrinology, sociology, anthropology and health impact of human separation and
attachment dynamics in dialogue with man’s religious and spiritual natures. Of course
the major focus of our gaze, among these other visual fields, must be on the psychiatry
and psychology of human development. Nevertheless the effort in this area will benefit
from a flexible and interactive give and take with other research area consultants given
the importance of their areas for human development. This will be particularly true in the
synthetic projects proposed.
We expect that the audience likely to submit applications for the Human
Development RFP funding will come from many different disciplines. This is reflected in
the above comments on the areas of study that will be needed to provide a full and deep
treatment of the topic in an analytic and synthetic way. Thus we would expect to hear
from developmental psychiatrists and psychologists with interests in each aspect of the
life cycle. But we would also be likely to hear from basic and cognitive neuroscientists,
neuropsychiatrists, behavioral neurologists, neuroendocrinologists, neuroimagers,
psychoanalysts, evolutionary biologists and psychologists, family theorists, sociologists,
anthropologists, anthropological theologians, and practitioners and caregivers.
Why is this area of human development important to our understanding of other
–regarding love and its manifestations? The answer to this question lies embedded in the
following key question: How does biophysically based “love”—the kind that flows from
the parent-child bond and then from spousal and family and social group
attachments—which is the result of brain evolution and individual human development,
give rise to unlimited or metaphysical love, unbuckled from the limits of physical love,
yet capable of making the physical world better?
Of course this is similar to that “mother” of all brain teasers –the “mind-body
problem.” How does mind with its unlimited mental vistas emerge from the if: then
decision hierarchies and the electrochemical tedium of the biological brain? For
generations, this has been considered an excellent example of a “bad” philosophical
problem in that we do not know enough about the brain let alone the mind to begin to

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answer it. Indeed Thomas Huxley coined the term “agnosticism” to describe his take on
the mind-body problem and on all of metaphysical philosophy, which included
psychology, for that matter. What we cannot measure in time and space is unknowable
and therefore unworthy of scientific commentary. This encapsulates Huxley’s agnostic
view of the mind-body question.
Perhaps Huxley would become more interested in the question of how humans
can develop unlimited love and genuine altruism if he understood how far the
neuroscience and psychiatry of infant, childhood and adult attachment have come after
what was called “ the decade of the brain” and as we enter what might be called “the
millennium of the mind.” This area is very fertile scientific ground these days for a
number of reasons. Bowlby’s concepts on attachment, separation and loss have been
operationalized by researchers like Waters (1990) and Main (1985) as have object
relations descriptions of “transitional relationships.” The term “transitional” has the
connotation of moving and flowing toward something. It instills the notion of moving
toward the peak of unlimited love into the discussion of human development.
Object relations theory sees man’s psychological maturation as a function of
developmental transitions involving the successful negotiation of separation challenges
through the auspices of solace providing, caregiving transitional figures (Horton, 1984).
The prototypical figure or object is the mother or parent and all future good and bad
objects will be more or less perceived and appreciated relative to this prototypical figure.
It is the job of the transitional figure to provide the attachment solution to the age
appropriate, developmental separation challenge. Thus for example, with good-enough
mother-child attunement, Piagetian object permanence will emerge as an attachment
solution to the separation challenge inherent in a mother’s disappearance from view. This
socioaffective imprinting of secure base attachment that begins in the emotional calm of a
mother’s love for her child has the power to reduce separation anxiety and to color our
future cognitive world. This affects our assessments of the basic goodness or badness of
our environments and contributes to our response selections accordingly. As our
development proceeds, in increasingly complexified ways, we are motivated to
immobilize or mobilize, avoid or approach, separate or attach…not love or love, partly
due to the transitional objects we have memorized and integrated.
And we are beginning to understand which areas of the brain are responsible for
these mind states. MacLean’s mammalian behavioral triad -- maternal nurturance, the
stereotypical separation cry and play-- has an important heuristic role to play in our
understanding of human development and the nature of unlimited love. One can
appreciate that expositions of unlimited love and its characteristics by those who live it,
such as Jean Vanier, partake of elements of this triad of mammalian behaviors that serve
to specify our evolutionary social survival strategy and heritage as mammals. Vanier
understands love in seven specific attitudes or motivations: to reveal, to understand, to
communicate, to celebrate, to empower, to be in community and to forgive (Vanier J,
1999). All can be traced to the triad which has its prominent neuronal constructs in a part
of the brain we call the thalamocingulate connection or more technically the basal ganglia
thalamocortical(anterior cingulate[ACA]/medial orbitofrontal[MOF]) circuit which forms
a key component loop in the brain’s motivation circuitry.
The triad needs the thalamocingulate for its expression and it’s the ACA that is
largely responsible for our response selection, after planning for execution takes place in

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our linked up pre-frontal cortex (PFC). Damasio (1994) believes the ACA is the brain’s
“fountainhead region.” He surmises that the ACA, probably in combination with the
PFC and the supplementary motor area, is the region where “emotion/feeling, attention,
and working memory interact so intimately that they constitute the cause for the energy
of both external action (movement) and internal action (thought animation, reasoning)”
(Damasio, 1994, p.71). We can now tease apart the emotional and cognitive components
of the important Brodmann area 24 of the ACA using various forms of the Stroop Color-
Word Naming Task (SCW) and functional magnetic resonance imaging (fMRI). Indeed
the cognitive conflict or interference instigated by the SCW can be linked with changes in
brain chemistry. Regional brain N-Acetyl aspartate (NAA) level, a marker of neuronal
density and function identified by in vivo proton magnetic resonance spectroscopy
(pMRS), has been shown to co-vary with cognitive interference levels (Grachev et al,
Molecular Psychiatry, 2001). A reduction of NAA in the right ACA has been shown in
high interference SCW subjects as compared to low interference subjects.
It is of interest in our discussion to point out that in a preliminary study, the ACAs
and the right MOF cortex (which is neurogenically and apoptotically molded during early
mother-infant attunement, misattunement and reattunement) light up with activity when
mothers listen to the separation cries of their babies while in the fMRI machine
(Lorberbaum et al, Depression and Anxiety, 1999). It has also been suggested in an
fMRI study that there is a neural basis of romantic love, with increased activity restricted
to the ACA and the medial insula, caudate and putamen bilaterally (Bartels and Zeki,
Neuroreport, 2000). In 2000, our group at the Mind-Body Medical Institute and at
Massachusetts General Hospital published the first neuroimaging report on meditation
(Lazar et al, Neuroreport, 2000). Using fMRI we found that meditation activates the
ACA along with the dorsolateral PFC, parts of the parietal cortex involved in attention,
amygdala, midbrain, hypothalamus and the hippocampus /parahippocampus in the
majority of subjects. In 2001, Newberg and colleagues used single photon emission
computerized tomography (SPECT) to confirm similar findings showing increased
regional cerebral blood flow (rCBF) activation in the dorsolateral PFC, ACA, orbital
frontal cortex and thalamus during meditation (Newberg et al, Psychiatry Research,
2001). Moral-personal (e.g., the footbridge dilemma) and moral-impersonal (e.g., the
trolley dilemma) conditional reasonings can also be studied using neuroimaging. In
September 2001, Greene and his colleagues at Princeton reported that moral-personal
conditions more so than moral –impersonal conditions were associated with increased
fMRI activations in the MOF and in the posterior cingulate cortex (Greene et al, Science,
2001). The accompanying editorial in Science argues that moral reasoning may rely on
emotions (Helmuth, Science, 2001). This emotion flows from the limbic system’s brain
motivation circuitry, which is sculpted in all of us developmentally by virtue of our
transitional relationships.
Of course these and other areas of the brain can be examined using separation and
attachment probes and self-regard and other-regard scenarios as surrogates for the most
important challenges in individual human development. As suggested above we are now
blessed with the tools to study quintessential higher human thought and behavior. When
someone makes a response selection in favor of unlimited love, what areas of that
person’s brain activate and deactivate? And what peculiar neurochemistry abides in
someone in that state and what of the person with an apparent trait for genuine altruism?

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And by what peculiar trajectory of transitional states of separation-attachment does
someone wind up with the biology and psychology and spirituality to give unlimited love
of a kind that is truly a whole greater than the sum of its parts?
And by the same token, what can we learn from the equally human development
of the narcissistic or sociopathic individual?
Stephen Post has written of Jean Vanier’s description, in his book Becoming
Human, of the 7 year-old girl afflicted with blindness and autism named Claudia. In a
community filled with love she was able to finally feel solace and communion—in other
words a secure base of attachment. Vanier sees clearly the developmental trajectory of
this little girl as she transitions from loneliness and insecurity through community and
love to the healing inner peace of attachment.
In the topic area of human development then, we will seek to study the
benefactors and the benefits of unlimited love—how they develop in the complex matrix
of influences that make us human. The following ten questions will serve to guide this
enquiry. If we can learn more about this process, perhaps we can, in an informed way,
help each other select responses reflective of unlimited love.

References:
1.Bowlby J. Attachment and Loss. Vols. I and II. Basic Books, NY, 1969.

2.Waters E, Kondo-Ikeumura K, Posada G, Richters J. Learning to Love:

Mechanisms and Milestones. In: Megan Gunner and L. Alan Stroufe (eds.) Minnesota
Symposia on Child Psychology. Vol. 23. Lawrence Erlbaum associates, Hillsdale NJ,
1990, pp217-255.

3. Main M, Kaplan N, Cassidy J. Security in infancy, childhood and adulthood: a

move to the level of representation. In: E. Waters, I. Bretherton (eds.) Growing Points
in Attachment Theory and Research. Monographs of the Society for Research in
Child Development. 1985;50(Serial No.209): 66-104.

4.Horton P. Solace. The Missing Dimension in Psychiatry. University of Chicago

Press, Chicago, 1981.

5.MacLean PD. The Triune Brain in Evolution. Role in Paleocerebral Functions.

Plenum Press, NY, 1990.

6.Vanier J. Becoming Human. Paulist Press, NY, 1999.

7. Damasio A. Descartes’ Error. Emotion, reason and the human brain. GP Putnam,
NY, 1994.

8. Grachev ID, Kumar R, Ramachandran TS, Szeverenyi NM. Cognitive interference

is associated with neuronal marker N-acetyl aspartate in the anterior cingulate cortex:
an in vivo (1) H- MRS study of the Stroop Color-Word task. Mol Psychiatry 2001;
6:529-539.

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 9. Lorberbaum JP, Newman JD, Dubno JR, Horwitz AR, Nahas Z, Teneback CC,
Bloomer CW, Bohning DE, Vincent D, Johnson MR, Emmanuel N, Brawman-
Mintzer O, Book SW, Lydiard RB, Ballenger JC, George MS. Feasibility of using
fMRI to study mothers responding to infant cries. Depress Anxiety 1999;10: 99-104.

10. Bartels A , Zeki S. The neural basis of romantic love. Neuroreport 2000;11:3829-
3834.

11. Lazar S, Bush G, Gollub R, Fricchione GL, Khalsa G, Benson H. Functional brain
mapping of the relaxation response and meditation using 3T fMRI. Neuroreport
2000;11: 1581-1585.

12. Newberg A, Alavi A, Baime M, Pourdehnad M, Santanna J, d’Aquili P. The

measurement of regional cerebral blood flow during the complex cognitive task of
meditation: a preliminary SPECT study. Psychiatry Res 2001;106:113-122.

13. Greene JD, Sommerville RB, Nystrom LE, Darley JM, Cohen JD. An fMRI
investigation of emotional engagement in moral judgement. Science 2001; 293: 2105-
2108.

14. Helmuth L. Moral reasoning relies on emotion. Science 2001; 293: 1971-1972.

II. Key Research Questions

Question 1

What are the variables in parent (mother) –child attunement and attachment that
produce a gradient toward healthy and even extraordinary other (object) love as
opposed to a gradient toward narcissism and even sociopathy? Another way to put
the positive question is: How does parental love received become transduced in the
child to the capacity to give love?

Significance: The issue of early attunement predicated adult predispositions to

self and other regard is seminal to any discussion of human development of altruism and
unlimited love. Leaving aside the possibility that the maternal-fetal relationship is also
important for brain structural development and later functioning, there is evidence that
the mother-infant dyad is the major modality for the emotional, separative breaking
through of the initial narcissistic union into the cognitive structure of a toddler’s
individuation accompanied by the need to find a new level of communion with the
mother. This separation-individuation process foreshadows future challenges and crises
that will call for attachment solutions, with object constancy as a prototype and the
integration of objects as a future psychological mechanism. Successful attunement-

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misattunement-reattunement as opposed to the unsuccessful version (e.g., Gordon
Parker’s “affectionless control”), may have certain structural and functional
consequences for the brain-mind that will affect the human development of other
regarding love as opposed to narcissism. Some child psychiatrists have referred to this
hierarchical developmental progression as the “moralization of attachment.”

Possible Methodologies:
a. Biological: Hypothalamic-pituitary-adrenal (HPA) and thyroid axis studies;
aminergic metabolite studies; platelet transmitter studies; cytokine studies;
neuropeptide studies (opioids; endogenous morphine; oxytocin, vasopressin);
galvanic skin responses; cold pressor test; EEG and qEEG; sleep architecture;
neuroimaging (SPECT, fMRI and pMRS, PET); MRS with N-Acetyl
aspartate; heart rate variability studies and cardiac responsiveness; and
neuromedical and mental status evaluations.
b. Psychosocial: Neuropsychological tests especially for frontal lobe and ACA
functioning; Ainsworth Strange Situation; Berkeley Adult Attachment
Interview (AAI); Attachment Self-Report; Social Adjustment Scale(SAS);
Psychopathic Personality Inventory(PPI); Questionnaire Measure of
Emotional Empathy (QMEE); Interpersonal Reactivity Index
(IRI);Aggression Questionnaire (AQ); Minnesota Multiphasic Personality
Inventory (MMPI); Cook-Medley Hostility Inventory (CMHI); Self Report for
Borderline Personality Scale (SRBPS); Personality Beliefs Questionnaire
(PBQ); Defensive Function Scale of DSM-IV – has altruism, suppression,
humor, anticipation, and sublimation at the mature end; social desirability
scales; Stilwell Conscience Interview; Parental Bonding Scale (PBS), Loyola
Generativity Scale (LGS).
c. Cultural: cultural attraction models; operationalization of the distribution of
mental representations and public productions which form the large scale
regularities we call “culture,” as the cumulative effect of micro-processes in
human populations (Sperber D. Explaining Culture. A Naturalistic Approach.
Blackwell Pubs, Cambridge, MA, 1996). Presumably these micro-processes
are comprised of biological and psychosocial components in individuals who
at their outset shared the universal human need for “secure base attachment,”
which Bowlby saw as our “environment of evolutionary adaptedness.” The
anthropological methodology would be based on the assumption that in
forming mental representations and public productions, to some extent all
humans, and to a larger extent all members of the same population at a given
time, are attracted in the same directions. (See Oliner studies on cultural as
well as religious aspects of rescuers and bystanders.) Cross-cultural studies
will be essential to tease apart what is uniform and what is discriminative
across cultures.
d. Religious/Spiritual Behavioral Assessment: Spiritual beliefs and religious
practices may foster altruistic behavior and unlimited love or they may not.
Instruments to quantify these variables are available. They include: Religious
Coping Index (RCI) of Koenig; the INSPIRIT and IPPA of Kass; Belief
Questionnaires of Linda George. Moral (Kohlberg) and Spiritual (Fowler)

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 Developmental Schemas may also be useful methodologies to consider
especially when juxtaposed with psychosocial development (Erikson etc.).
Meditation studies now employ functional neuroimaging as well as other
technologies such as heart rate variability via ambulatory ECG monitoring.
e. Hermeneutical: Subjective accounts and discursive analyses (Main M.
Introduction to the special section on attachment and psychopathology: 2.
Overview of the field of attachment. J Consult Clin Psychol 1996; 64:237-
243) of them to approach intersubjectivity may be useful in approaching direct
knowledge of unlimited love rather than more observational knowledge. A
good example of this methodology is the work of Dan McAdams using the
Life Story Interview (LSI) and the Thematic Aperception Test (TAT) to study
generativity and themes of agency and communion in adult autobiography
(Mansfield ED, McAdams DP. Generativity and themes of agency and
communion in adult autobiography. Pers Soc Psychol Bull 1996; 22:721-731).

[These various categories can be envisioned as part of a matrix of influences on

the human development of unlimited love and altruism that will be available for use in
answering all 10 questions. Research in this area will involve one or more categories in
the matrix. There will likely be a preference for more categories when interactive
associations and effects are sought.]

An example of a study using methodology that can be used to address Question 1:

Waters E, Merrick S, Treboux D, Crowell J, Albersheim L. Attachment security in
infancy and early adulthood: a twenty year longitudinal study. Child Dev 2000; 71:684-
689. Sixty white middle class infants were examined in the Ainsworth Strange Situation
(SS) at 12 months of age; 50 of these participants were recontacted 20 years hence and
interviewed using the Berkeley Adult Attachment Interview. Interviewers were blind to
the original SS classification. Seventy two percent of the infants received the same secure
vs. insecure attachment classification in early adulthood. (p< .001) Eight of 18 or 44% of
the infants whose mothers reported negative life events changed attachment
classifications from infancy to early adulthood. As predicted by attachment theory, a
negative life event such as loss of a parent, parental divorce, life-threatening illness of
parent or child, parental psychiatric disorder, and physical or sexual abuse by a family
member was an important factor in category change. Only 22% or 7 of 32 infants whose
mothers reported no such events changed classification (p<.05). Results suggest that, as
Bowlby hypothesized, individual attachment security differences can be stable over time
yet remain open to change in light of experience. A variety of research designs,
measurement strategies and study intervals will be needed to clarify the factors and
mechanisms that produce stability and change.

[One could envision making additions to this study design from the matrix. For example,
a longitudinal study could start with the SS test in infancy and 20 years hence finish with
the AAI and a moral reasoning/self vs. other regard scenario choice subjects would need
to make while undergoing fMRI.]

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 Background: There is very interesting work to suggest that the right medial
orbitofrontal (MOF) cortex and the anterior cingulates (limbic cortices) are involved both
in the parent and child in the experience of both attunement and misattunement. This is
thought to have consequences for how the limbic cortices are sculpted. (Schore AN. The
experience dependent maturation of a regulatory system in the orbital prefrontal cortex
and the origin of developmental psychopathology. Development and Psychopathology
1996;8:59-87). Young children must experience “secure base attachment” in order to do
the work of individuating in a healthy way. As they develop they need moderate arousal
energy (the R MOF is particularly important in modulating the autonomic nervous system
and visceral functions as are the ACAs) in order to promote appropriate interactions with
surroundings. “Particular socioaffective imprinting experiences” (Schore) of attachment
during which the mother’s limbic output, particularly that of the MOF region, will
provide a premotor template for the imprinting of the child’s developing corticolimbic
regions, may be of major importance. Loving socialization and attunement quality will
impact on the child’s MOF/ACA development. Mothers appear to accomplish attunement
with moderate arousal by initiating and participating in mirroring and refueling, which
increases arousal; shame socializing interactions which brake arousal; and interactive
repair relations which re-establish optimal arousal after attachment lapses. This is the
“goal corrected system” for secure base attachment that Bowlby referred to. When
mothers are attuned (and granted this is easier when temperaments are in harmony),
secure base dyadic attachment and basic trust that life, self and object have worth and
meaning, will have a better chance of developing. The attraction to a loving stance in the
world may increase. When there is chronic misattunement, insecure-avoidant and
insecure–resistant conditions in children may emerge. The question is whether these
insecure states would raise the threshold for other regarding love and reduce the chances
of a child becoming a “causa efficiens” of love.

Key Research Studies:

1.1 Wiesenfeld AR, Whitman PB, Malatesta CZ. Individual differences among adult
women in sensitivity to infants: evidence in support of an empathy concept. J Pers
Soc Psychol 1984;46:118-124. Emotional and physiological responsivity to 5-
month old infant signals (smiling, quiescent, crying) was assessed in individuals
who differed markedly in their level of empathy (18 high empathy and 20 low
empathy subjects). High empathy subjects had larger electrodermal responses,
matching facial responses, more extremes of happiness and sadness, a stronger
desire to pick up the infants and a trend toward higher cardiac responsiveness.
High empathy individuals may be more emotionally responsive to infant
emotional stimuli and hold different values concerning caregiving behavior.

[Neuropeptide and HPA studies could be added to this methodology as could

functional neuroimaging. The RCI and the INSPIRIT and the IPPA could be
instruments included to study the variables of religious behavior and spirituality
in effecting empathy and caregiving. The PBI could also be employed to get
retrospective data on the quality of the subjects’ parenting.]

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1.2 Zahn-Waxler C, Friedman SL, Cummings EM. Childrens’ emotions and
behaviors in response to infants’ cries. Child Dev 1983; 54: 1522-1588.
Variations in reactions to young infants’ preterm and full term cries were studied
in 60 late preschool to preadolescence age children. Each child overheard a cry in
an adjacent room, followed by the entry of a mother, carrying her infant and
looking for the “crying” infant’s bottle. An interview of each subject followed.
Self-reports of empathy, verbalized intentions to help, actual helping responses,
and observer ratings of negative emotion were measured. Negative emotion
occurred in all age groups. Prosocial behaviours increased with age. Negative
emotions were inversely correlated with prosocial responses. Type of cry could be
distinguished but made no difference in responses.

1.3 Hinchey FS, Gavelek JR. Empathic responding in children of battered mothers.
Child Abuse Negl 1982;6:395-401. 32 mothers and their preschool children (50%
female) were the subjects in this study assessing the empathic abilities of children
whose mothers were victims of conjugal abuse. Half of the mother sample had
been abused. Home Climate Questionnaire was used to test the instability of
familial relationships. Abusive husbands were found to be more verbally
aggressive with their children though not physically abusive toward them. A 2
way MANOVA revealed that children of battered mothers showed significant
downward effects on 3 out of 4 measures of empathy-- role-enactment, social
inference and role-taking. Marital discord of this type may have early and
pervasive influences on the empathic abilities of children.

[A longitudinal approach with subsequent measurements of empathy using the QMEE

for example could be grafted onto this design along with measures of altruism and a
hermeneutical approach (LSI) to life history and other regarding love.]

1.4 Singer LM, Brodzinsky DM, Ramsay D, Steir M, Waters E. Mother-infant

attachment in adoptive families. Child Dev 1985;56:1543-1551. The quality of
attachment relationships in adoptive and non-adoptive mother-infant pairs was
assessed using data from 2 separate samples using the SS paradigm. Infants were
13 and 18 months of age. No differences in mother-infant attachment between
nonadopted and adopted subjects. No relation was found between attachment
quality and perceived social support, infant developmental quotient, infant
temperament, number of foster homes experienced by the infant, or infant age at
placement.

[Nature and quality of attachment and attunement in mothers of adoptees vs

nonadoptees can be further explored using other elements in the matrix and
employing a prospective design to look at measures of empathy and altruism
development. A retrospective design to see how being adopted has impacted on
these variables would also be of interest.]

1.5 Hesse E, Main M. Disorganized infant, child, and adult attachment: collapse in
behavioral and attentional strategies. J Am Psychoanal Assoc 2000; 48:1097-

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 1127. In addition to Insecure-avoidant and Insecure-resistant infant categories in
the SS condition, there is also the disorganized/disoriented (Group D) category
that has correlates in child and adult attachment. The infant D category is assigned
when there are noted interruptions and anomalies in organization and orientation
during the SS. The D category is felt to be independent of temperament. In this
study former infant D subjects at age 6 were found to be controlling (D-
Controlling) toward their parents. Drawings and separation related narratives
suggested the persistence of fear and disorganization (D-Fearful). As adults these
same subjects were found to show marked lapses in reasoning and disjointed
discourse in the discussion of loss or abuse during the AAI. They were coded as
“Unresolved/disorganized” (U/d) as far as their adult attachment status. U/d status
in adult parent predicts risk of infant D attachment. The authors propose that
Bowlby’s theory is expanded with the proposal that certain forms of frightening
parental behavior will stimulate contradictory biological tendencies and
behavioral propensities to both approach and avoid the parent. Maltreated infants
may thus experience tremendous dissonance leading to disorganization. They
surmise that infant D attachment may sometimes signify a second generation
effect of unresolved parent responses to trauma. Furthermore infant D attachment
appears to predict disruptive/aggressive and dissociative disorders in childhood
and adolescence and U/d adult attachment often appears in psychiatric and
criminal cohorts.

[Another example of a longitudinal design, this time using the SS, AAI and
discursive analysis, that can be adapted and enriched by the addition of other
matrix components. Comparisons of the trajectories toward altruism and
unlimited love on the one hand and narcissism and sociopathy on the other may
be made using cohorts of infants initially categorized as secure attachment and
those categorized as infant D.]

1.6 George C, Main M. Social interactions of young abused children: approach,

avoidance, and aggression. Child Dev 1979; 50:306-318. 10 abused toddlers
(ages 1-3 years) were compared with 10 matched controls in a daycare setting
during social interactions with both caregivers and peers. Abused toddlers more
frequently physically assaulted peers; “harassed” and threatened caregivers
verbally and non verbally; and were much less likely to approach their caregivers
in response to friendly gestures. When approached in a friendly manner, abused
toddlers more frequently avoided peers and caregivers or combined approach
movements with avoidance movements.

[Attempts to link prosocial behaviors (see #2 above) in older children to early

childhood attachment experiences would be of interest. It would be of interest
also to see what possible intervening variables and corrective emotional
transitional relationships are powerful enough to change the trajectory of a child
from one of avoidance or disorganized approach and aggression to one of mature

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 attachment, empathy and prosocial decisionmaking—all of which may be
antecedent to the capacity for adult altruistic love.]

1.7 Main M, Goldwyn R. Predicting rejection of her infant from mother’s

representation of her own experience: implications for the abused-abusing
intergenerational cycle. Child Abuse Negl 1984; 8:203-217. Child battering
parents appear to pass on 3 primary behavioral characteristics to their children:
aggression dyscontrol, aversive unsympathetic response to other’s distress, and
self-isolating tendencies. These behaviors can appear in toddlerhood. The toddlers
of relatively rejecting mothers in normal samples also appear to develop these
behaviors to a lesser degree. The authors surmise that there may be a
psychological continuum from “normal” rejection to the actual experience of
abuse. They go on to present preliminary findings from their ongoing study of
social development in normal nonabusive families. 30 AAI interviews were done
with mothers and the apparent experience of a subject’s own mother as rejecting
was observed in the laboratory to correlate with the subject’s rejection of her own
infant. These mothers also showed cognitive distortions in recalling their
childhoods, reflected in idealization of a rejecting parent, poor recall of childhood,
and incoherency in discussing attachment experience.

[Studies like these, of normal mothers and adults, can make use of attachment
measures combined with variables from the matrix of components above to stratify
propensities to develop the capacity for unlimited love and mature defenses vs. the
risks for narcissism and other cluster B personality disorders (Antisocial, Borderline,
Histrionic as well as Narcissistic) and immature defenses.]

Question 2

Do those high on altruism or empathy scales do better at choosing “attachment

solutions” during separation stress or challenge?

Significance: At each important juncture in human development there is a

naturally occurring or contingently applied separation challenge, which requires some
form of response selection on the part of the individual. Many influences impact on the
response including genetic endowment, perinatal experience, temperament, mother-infant
attunement, parent- family relations, childhood events, peer interactions, neighborhood
and culture, socioeconomics, religious belief etc. Regardless of these complexifying
systemic influences, they will be processed in the brain, as sensorimotor-analyser
effecter, according to what Kraemer calls a “psychobiology of attachment” (Kraemer
GW.A psychobiological theory of attachment. Behavioral Brain Sciences 1992; 15:493-
541). Thus the separation challenge of separation–individuation is met with the
attachment solution of object constancy and about at the same time at age 2, the child
develops the unique human competence to empathize, with its obvious relevance to
morality (Kagan J. Morality, altruism and love. Presented at the Conference: Empathy,

12
Altruism and Agape. October 1-3,1999. Cambridge, MA); the separation challenge of
adolescence is met with the rapprochement of early adulthood; the separation challenge
of the illness experience is met with the attachment solution of the doctor-patient
relationship and the buffering of social attachments (both of which provide healing
effects). Those who have arrived in adulthood with high levels of empathy (a
multidimensional construct with physiological, emotional, cognitive, communicative and
relational components) or altruism may have a propensity to seek attachment solutions to
separation challenges. This may account for the adaptational nature of what may be
considered the mature psychological defense of altruism and it’s role in positive
psychology (Vaillant GE. Adaptive mental mechanisms. Their role in positive
psychology. Am Psychol 2000;55:89-98). At the same time when one receives loving
and consistent attachment as a solution to one’s separation challenge, even if there have
been grave deprivations in the past, there may be the chance to experience what Kohut
has called a “corrective emotional experience” to heal even very early misattunement
scars. We know that Francene Benes has established in her neuropathological studies that
myelination occurs throughout life and particularly in the superior medullary lamina,
which serves as a highway between the parahippocampus and the anterior cingulated
cortex [Benes F. Brain development, vii. Human brain growth spans decades. Am J
Psychiatry 1998; 155:1489]. We also know that the neurogenesis/apoptosis equation is
effected by stress, so there are neuronal constructs to support this psychological
developmental view [McEwen BS. The neurobiology of stress: from serendipity to
clinical relevance. Brain Res 2000; 86: 172-189]. It may be that the mirroring, refueling
and imprinting roles of parental figures we encounter at pivotal times throughout life
have the neurobiological influence to effect changes in behavior in the direction of loving
choices for others.

Key Research Studies:

2.1 Stilwell BM, Galvin M, Kopta SM, Padgett RJ, Holt JW. Moralization of
attachment: a fourth domain of conscience functioning. J Am Acad Child Adolesc
Psychiatry 1997; 36: 1140-1147. The authors attempt to define discrete
developmental levels of understanding, regarding ways in which normal children
and adolescents link remembered and current attachment experiences to their
moral belief system and to study the correlation between this progression and
previously identified stages of conscience conceptualization. Interviews with 132
normal 5 to 17 year old volunteers using the Stilwell Conscience Interview with
its’ moralization of attachment section were performed. ANOVA and covariance
showed a correlation between the 5 attachment levels and the 5 moral
conceptualization stages. The authors conclude that in normal development, the
moralization of attachment is a domain of conscience functioning (akin to
Kagan’s concept of the human uniqueness in applying the categories good and
bad to objects in association with self-awareness of guilt and the development of
conscience). It appears to follow a 5 stage hierarchical developmental
progression: 1) the child’s sense of security and empathic responsiveness become
paired with a sense of moral obligation; 2) the child incorporates caretaker rules;
3) the child understands how empathy modifies strict rule-following; 4) the older
child chooses idols and ideals reflecting earlier learning in attachment

13
 relationships; 5) the adolescent visualizes self as a moral standard bearer or as a
teacher.

[One can study how moralization of attachment level affects responses to a

separation challenge vignette. Any of a number of components from the
matrix can be studied in relation to the attachment level profiling. In adult
practitioners of unlimited love retrospective analysis of their own moralization
of attachment would be of interest. The intersection of spiritual development a
la Fowler with the moralization of attachment would also be important to
study.]

2.2 Eisenberg N, Carlo G, Murphy B, Van Court P. Prosocial development in late

adolescence: a longitudinal study. Child Dev 1995; 66:1179-1197. Researchers
looked at change in prosocial moral reasoning longitudinally over 15 years. The
interrelationships among moral reasoning, prosocial behavior, and empathy-related
emotional responses were examined in 17 to 20 year olds. Higher level reasoning
increased in adolescence and early adulthood and was higher in females than in
males. There was some evidence of relations among prosocial reasoning, prosocial
behavior, sympathy, and perspective taking.

[Applications here would be similar to above.]

2.3 Hay DF, Castle J, Davies L, Demetriou H, Stimson CA. Prosocial action in very
early childhood. J Child Psychol Psychiatry 1999; 40: 905-916. Sixty six children at
18, 24, and 30 months and then again 6 months later were observed for their sharing
activity with familiar peers at home. Most children shared less as they grew older, but
the oldest girls shared more, usually with other girls. Boys were more likely to show
reciprocity in sharing. Individual differences were relatively stable over time and
sharing was linked to sensitivity to a peer’s distress. In boys higher rates of sharing
were associated in mother’s ratings with negative ratings of personality traits.

[Future longitudinal studies in this vein could focus on associating sharing at this
age with prior mother-child attunement as well as with future prosocial behaviors
including altruistic acts. Would also be fascinating to investigate the negative
reinforcement mothers may give their sons regarding prosocial behaviors when
their children start to interact with peers, perhaps taking it as a sign of weakness.]

2.4 Litvack-Miller W, McDougall D, Romney DM. The structure of empathy during

middle childhood and its relationship to prosocial behavior. Genet Soc Gen Psychol
Monogr 1997; 123: 303-324. This study was an investigation of the structure and
development of empathy during middle childhood and its relationship to “altruism”
understood in terms of prosocial behaviors such as making monetary donations and
volunteering time. A cohort of 478 second, third and sixth grade students completed
an altruism questionnaire and a social desirability scale as well as the Interpersonal
Reactivity Index. Students were also rated by teachers on their prosocial behaviors

14
 such as sharing. Results showed that empathy has 4 components: perspective taking,
fantasy, empathic concern, and personal distress. Girls were more empathic than
boys; older children showed more empathic concern than younger children. Only
empathic concern and perspective taking were significant predictors of prosocial
behavior.

[In addition to doing longitudinal studies as mentioned for #3 above, studies

designed to tease out physiological reasons for a more predominant “tend and
mend” approach in females as opposed to a more “fight or flight” approach in
males when faced with distress would be of interest. Oxytocin vs. vasopressin?
(Uvnas-Moberg K. Oxytocin may mediate the benefits of positive social
interaction and emotions. Psychoneuroendocrinology.1998; 23: 819-835).
Estrogen receptors (ER-alpha) and their effects on brain blood flow increase?
(Duckles S et al. J Appl Physiol 2001.]

2.5 Davis MH, Mitchell KV, Hall JA, Lothert J, Snapp T, Meyer M. Empathy,
expectations, and situational preferences: personality influences on the decision to
participate in volunteer helping behaviors. J Pers 1999; 67: 469-503. Evidence
suggests dispositional empathy is associated with the degree of help observers will
provide to those in need. These researchers studied whether empathy affected one’s
willingness to enter situations in which needy “targets” will be found. They
hypothesized that dispositional empathy influences such situational preferences. They
also hypothesized that this influence is mediated by the expected emotions one feels
are likely to emerge in such situations. In study 1 hypothetical situation judgements
supported both hypotheses. In study 2 when participants were led to believe their
decisions would actually lead to encountering needy targets, both propositions were
also supported. The model also found support in study 3 which examined actual
community volunteer experiences.

[Further study might focus on the biological and psychological factors involved in
this almost chemotactic gradient toward the emotional state attendant to
responding with love and attachment solutions to those in need. Many of the
strategies and tools outlined in the matrix can be used in pursuit of this
understanding.]

Question 3

Is the generativity that develops in later adult life on a continuum of human

development with other–regarding love and unlimited love?

Significance: When adults give of themselves and their wisdom to the next
generation, they are not necessarily contributing to the persistence of their personal
germline. Yet they are giving of themselves to others often in an effort to enhance the
next generation’s survival advantage. One can look at this as the selfish desire to
perpetuate one’s memes if not one’s genes. On the other hand one can explore the

15
possibility that generativity flows from other-regarding love for the youth of the
species—perhaps another echoing of the bonds of the parent-child. This line of inquiry
might examine the connections between Erikson’s 7th stage of middle adulthood and
Kohlberg’s post conventional moral development stage 6 of personal principles
culminating in Fowler’s 6th stage of spiritual development focused on universalizing
faith, love and the needs of others.

Key Research Studies:

3.1 McAdams DP, Diamond A, de St Aubin E, Mansfield E. Stories of
commitment. The psychosocial construction of generative lives. The authors
studied the internalized life stories of 40 highly generative people and 30 less
generative people, matched for demographic factors. Generative individuals
tended to reconstruct the past and anticipate the future as variations on a
prototypical commitment story. The protagonist in this story: a) experiences an
early family blessing or advantage (becomes a standard bearer?); b) is sensitized
to the suffering of others at an early age; c) has a stable, clear and compelling
ideology to guide him; d) seeks to create good outcomes out of bad
circumstances; e) sets goals for the future to benefit society. Commitment stories
may fuel a modern adult’s generativity. Interpretations of stories that inspire
people using nomothetic conventions may be a fruitful new research area.

[The functional neuroimaging activation of the brain motivation circuitry with

special attention to the PFC and the ACA would be of interest during recounting
of a prototypical commitment story in generatives and non-generatives]

3.2 Mansfield ED, McAdams DP. Generativity and themes of agency and
communion in adult autobiography. Pers Soc Psychol Bull 1996; 22:721-731.
Seventy subjects ages 25 to 72 were administered the TAT and a Life-Story
Interview (McAdams,1993) in an effort to study reconstructions of their
autobiographical pasts in terms of “agency” and “communion”. Seven scenes
(peak experience, turning point, earliest memory, important
childhood/adolescent/adult memories, and any other memory) were judged on 4
themes of agency and communion. Greater levels of communion were found in
the highly generative especially in terms of dialogue and care/help themes. They
also showed greater agency/communion integration.

[Markers for higher agency/communion integration might be searched for using

tools in the matrix at various stages in human development. If people truly only
individuate in community and self-realize only through the experience of self-
giving (Williams DD. The spirit and forms of love. Harper and Row, NY, 1968),
then it would be important to understand how this synthesis in highly generative
loving individuals takes place, perhaps resulting in capacity for unlimited love.]

3.3 McAdams DP, Hoffman BJ, Mansfield ED, Day R. Themes of human agency
and communion in significant autobiographical scenes. J Pers 1996; 64: 339-377.
Three studies looked at the coherence in personality across autobiographical

16
memories, social motives and daily goals. The TAT, autobiographical exercises
and the Life- Story Interview were used. Individual themes of self-mastery, status,
achievement and empowerment were correlated with TAT measurements of
achievement and personal strivings associated with strength and success. Themes
of love/friendship, dialogue, care/help and community were correlated with
intimacy motivation, needs for affiliation and nurturance and personal strivings
associated with warm relationships.

[Physiological and endocrinological correlates of individual themes measured

with these instruments would be of great interest. It would also be interesting to
measure physical and emotional pain tolerance as a function of autobiographical
themes. The ACA may be involved in response selection and motivation as well
as pain apperception.]

3.4 McAdams DP, Reynolds J, Lewis M, Patten AH, Bowman PJ. When bad
things turn good and good things turn bad: Sequences of redemption and
contamination in life narrative and their relation to psychosocial adaptation in
midlife adults and in students. Pers Soc Psychol Bull 2001; 27: 474-485. Oral life
narratives from 269 midlife adults and written life narratives from 125 college
students were analyzed for redemption (bad turned to good) and contamination
(good turned to bad) imagery. Adults scoring high on generativity showed
significantly higher levels of redemption and lower levels of contamination
sequences. Redemption sequence scores correlated with well-being.

[This study raises many cart and horse questions. Does generativity lead to
redemption or does redemption lead to generativity? Is generativity related to
optimism built on experience of redemption as opposed to pessimism built on
contamination event experience? Or as John Wooden would say: “Things turn out
best for those who make the most of how things turn out”. Does the experience of
religious belief change contamination to redemption and inspire generativity? The
RCI, INSPIRIT, IPPA and Belief questionnaires could be enlisted in studies like
these. An analysis of important transitional relationships and experiences across
the life cycle might help establish causality.]

3.5 Peterson C, Seligman ME, Vaillant GE. Pessimistic explanatory style is a risk
factor for physical illness: a thirty-five year longitudinal study. J Pers Soc Psychol
1988; 55:23-27. Pessimistic explanatory style (the belief that bad events are
caused by stable, global and internal factors) was evaluated in 99 graduates of
Harvard College in the years 1942-1944 at age 25 via open-ended questionnaires.
Physical health between the ages 45 to 60 was predicted by explanatory style with
pessimism correlating with poor health in middle and late adulthood.

[Does generativity, if related to optimism, predict better physical health as well as

well being? Longitudinal studies of physical health and generativity and other
regarding love would be of importance.]

17
3.6 Ackerman S, Zuroff DC, Moskowitz DS. Generativity in midlife and young
adults: links to agency, communion and subjective well-being. Int J Aging Hum
Dev 2000:50:17-41. This study of 58 young adults revealed that generativity was
independently predicted by agentic (power) and communal (love) interpersonal
orientations, with agency a stronger predictor for young men and communion a
stronger predictor for young women. Among 98 midlife adults studied,
generativity was correlated with positive affect, life satisfaction and work
satisfaction and was independently predicted by agentic (in men) and communal
(in women) traits. Generativity may be a stronger predictor of well-being in
midlife adults.

[Studies on gender differences in generativity, empathy and altruism development

would be welcome. Focus could be on psychosexual features of development as
well as neurohormonal influences]

3.7 Vaillant GE, Vaillant CO. Natural history of male psychological health, XII: a
45-year study of predictors of successful aging at age 65. Am J Psychiatry 1990;
147: 31-37. A predictor of mental health was maturity of defenses before age 50.
These include altruism, suppression, humor, anticipation, and sublimation while
immature defenses include hypochondriasis, fantasy, dissociation, acting out,
projection and passive aggression. A warm childhood environment predicted
physical health at age 65 but not mental health.

[Studies of a longitudinal nature like this can be adapted to include hard measures
of generativity and altruism]

3.8 Vaillant GE, Davis JT. Social/emotional intelligence and midlife resilience in
schoolboys with low tested intelligence. Am J Orthopsychiatry 2000; 70:
215-222. In this prospective fifty-year study, 73 inner city boys with mean IQ
of 80 were compared at age 65 with a sample of 38 boys with IQ of 115. Half
of the low IQ sample had incomes as high and children as educated as those
men with high IQs. These resilient low IQ men were more likely to be
generative, use mature defenses and enjoy warm object relations.

[Studies aimed at social/emotional versus cognitive/intelligence promoters of the

human capacity for unlimited love would be of importance.]

3.9 Younnis J, McLellan JA, Yates M. Religion, community service, and identity
in American youth. J Adolesc 1999; 22: 243-253. Data from nationally
representative samples were reviewed and led to the conclusion that many
contemporary youth who take religion seriously are more engaged in their
schooling but also in the betterment of their communities and the
development of identities that presage healthy lives.

18
 [Markers of religious development and behavior can be correlated with evidence
of altruistic and loving attitudes and actions.]

Question 4

Is there anything we can learn about the human development of altruistic or

unlimited love capacity from a greater understanding of the development of cluster
B personalities built on the core of entitlement?

Significance: One of the enduring problems all societies face is the tremendous
physical, emotional and economic burden of narcissistic and sociopathic personalities.
These personalities have a great difficulty mounting an other-regarding love response in
any social situation. Indeed a lack of empathic understanding makes such love well nigh
impossible. It has been known for a long time for example that sociopathic individuals
cannot produce a galvanic skin conductance response when faced with a scene that
normally evokes an empathic response. If we could pinpoint the variables that, due to
their presence or absence, increase the gradient toward entitlement, immature defenses,
and lack of love as opposed to other-regard, mature defenses, and love, we might have a
deeper insight into factors that reduce the former tendencies and increase the latter ones.

Key Research Studies:

4.1 Sandoval AM, Hancock D, Poythress N, Edens JF, Lilienfeld S. Construct
validity of the Psychopathic Personality Inventory (PPI) in a correctional sample.
J Pers Assess 2000; 74: 262-281. The authors looked at the relationship between
the PPI and 4 theoretically related constructs of empathy, aggression, work ethic
and borderline personality disorder (BPD). The relationship between heroism and
the PPI was also investigated in the sample of 100 male inmates. Other
questionnaires used were the Questionnaire Measure of Emotional Empathy, The
Aggression Questionnaire, the Protestant Ethics Scale, the Borderline Personality
Self-Report, and the Activity Frequency Scale. PPI was negatively c/w empathy
and positively c/w aggression and BPD. PPI was not significantly negatively c/w
work ethic and no significant relations with heroism were found on exploratory
analysis.

[Studies contrasting empathy and aggression measures and the variables (e.g,
maternal nurturance, head trauma, abuse) that predict them across the life cycle in regard
to their effects on psychopathy versus altruism would be of interest]

4.2 Soldz S, Vaillant GE. A 50-year longitudinal study of defense use among
inner city men: a validation of the DSM-IV defense axis. 306 inner-city men were
rated from interviews at age 47 and these ratings were analysed by cluster
analysis with 5 clusters emerging. Correlates of cluster membership were looked
at employing data from the 50-year longitudinal study of these men. Cluster 1=

19
greatest use of mature defenses c/w best psychosocial and health variable
functioning. Cluster 2 and 3 = primarily neurotic defenses c/w intermediate
outcomes. Clusters 4 and 5= primarily immature defenses c/w worst functioning.
Cluster 4= action immature c/w sociopathy, alcohol, marital instability. Cluster 5=
projection-fantasy immature c/w less sociopathy, alcohol and marital instability.

[DSM-IV hierarchy of non-psychotic defenses can be added to the analysis of the

human development of altruism and sociopathy.]

4.3 Mayes LC, Cohen DJ. The social matrix of aggression. Enactments and
representations of loving and hating in the first years of life. Psychoanal Study
Child 1993; 48:145-169. A psychoanalytic study of the development of
aggression, which is seen as having a major role in the shaping of the child’s
predominant modes of viewing and experiencing the world. Any developmental
theory of aggression must deal with the central question of how aggression toward
another mixes with desire for another in the formation of early capacities for
object relatedness. Aggression is first experienced, shaped, refined, and
remodeled in the context of nurturing or non-nurturing relations. It is modified in
the first 5 to 6 years of life. Therefore the capacity to interpret the intentions of
others and attribute affects, beliefs and other mental states to others is crucial to
these modifications. Experiences of violence, abuse and deprivation influence the
child’s experience of his and other’s aggression and prevent the normal
modulation, through attunement mechanisms, of aggression. (Neuropsychiatric
disorders of early childhood will also prevent this modulation.)

[Object relations theory and psychoanalytic approaches can inform the

investigation of aggression and empathy development.]

4.4 Beck AT, Butler AC, Brown GK, Dahlsgaard KK, Newman CF, Beck JS.
Dysfunctional beliefs discriminate personality disorders. Behav Res Ther 2001;
39: 1213-1225. The Personality Belief Questionnaire (PBQ) was completed at
intake by 756 psychiatric outpatients who were also assessed for 5 personality
disorders using blinded interviewer standardized clinical interviews. Subjects with
avoidant, dependent, obsessive-compulsive, narcissistic, and paranoid disorders
endorsed PBQ beliefs that are theoretically linked with their particular disorders.

[The PBQ can be a useful tool in studies looking at the differences in aggression
and empathy in various adult personalities.]

4.5 Krueger RF, Hicks BM, McGue M. Altruism and antisocial behavior:
independent tendencies, unique personality correlates, distinct etiologies. Psychol
Sci 2001; 12:397-402. These researchers bridge the gap between the literatures of
altruism and sociopathy by focusing on 3 fundamental questions. First: Are
altruism and antisocial behavior opposite ends of a single dimension, or can they
co-exist in the same individual? Second: Do altruism and antisocial behavior have
the same or distinct etiologies? Third: Do they stem from the same or distinct

20
 aspects of a person’s personality? Their data suggests that they are uncorrelated
tendencies arising from different sources. Altruism was linked to familial
environments, non-familial unique environments, and personality traits of positive
emotionality. Antisocial behavior was linked to genes, unique non-familial
environments, and personality traits of negative emotionality and a lack of
constraint.

[More study linking the literatures of altruism and sociopathy is needed. If they
are on separate tracks how can the altruism track be “greased” and the sociopathy
track be impeded?]

Question 5

What are the neuropsychiatric elements of the human development of love?

Significance: Much of the significance of this question has already been

discussed in the Introduction. The neurobiology of brain development, the ratio of
neurogenesis to apoptosis, effects of separation and stress and attachment and security on
structure and function can all now be cross-referenced with neuroimaging strategies and
neurochemical assays to give a more complete picture of the neurodevelopment of love.

Key Research Studies:

5.1 Bartels A, Zeki S. The neural basis of romantic love. Neuroreport 2000;
11:3829-3834. The activity in the brains of 17 subjects who were deeply in love
was scanned using fMRI, while they viewed pictures of their partners, and
compared with the activity stimulated when they were viewing pictures of 3
friends of similar age, sex and duration of friendship as their partners. The activity
attributed to romantic love was restricted to the ACA and the medial insular
cortex and in the subcortex, to the caudate and the putamen, all bilateral in
distribution. The posterior cingulategyrus and the amygdala were deactivated.

[Studies such as this can be used to start to tease apart the brain activation
differences between romantic love and unlimited love. Subjects could have been
tested not only with pictures of partners but pictures and stories to evoke altruistic
or agapic affects.]

5.2 Carter SC, Macdonald AM, Botvinick M, Ross LL, Stenger A, Noll D, Cohen
JD. Parsing executive processes: Strategic vs. evaluative functions of the
anterior cingulated cortex. The researchers tested ACA functioning during the
executive processes of cognition using the Stroop color naming task and
event-related fMRI. It is known that the ACA serves a strategic function
involving response selection for action. This involves the ability to diminish
the competition between potential responses to a stimulus. Another theory
holds that the ACA performs an evaluative function, reflecting the degree of

21
 response conflict elicited by a potential task, in the service of executive
control as part of a circuit with the dorsolateral PFC, which then goes on to
implement strategic processes. In this study of 12 healthy, young, right-
handed male subjects, the ACA was significantly more active when conflict
was high and control is low than when conflict is low and control is high.
This suggests that the ACA serves an evaluative function.

[Use of this protocol could be used to study response selection in

standardized scenarios requiring altruistic decision-making, manipulating
conflict and control variables.]

5.3 Grachev ID, Kumar R, Ramachandran TS, Szeverenyi NM. Cognitive

interference is associated with neuronal marker N-acetyl aspartate in the
anterior cingulated cortex: an in vivo (1) H-MRS study of the Stroop Color-
Word (SCW) task. 15 normal subjects were studied with the SCW as a
cognitive interference task. SCW scores were significantly c/w low NAA in
the right ACA (P<0.01). Spectroscopic brain mapping of NAA, the marker of
neuronal density and function, to SCW task measures may differentiate
between high and low interference in normals.

[Studies using pMRS and NAA markers of neuronal density and function
(reduced in diseases such as SLE, MS, and Alzheimer’s) can begin to
pinpoint the linkage between human development of capacity to love and
neuronal developmental capacity along with the forays into whether nurturing
love history builds neuronal capacity along with the capacity to love.]

5.4 Carter CS, MacDonald AW, Ross LL, Stenger VA. Anterior cingulated
cortex activity and impaired self-monitoring of performance in patients with
schizophrenia: An event-related fMRI study. Am J Psychiatry 2001; 158:
1423-1428. 17 schizophrenic and 16 matched control subjects were studied
with fMRI while doing a continuous performance task. The ACA of
schizophrenics showed lower error –related activity and less performance
adjustment reflecting poorer evaluative functioning and poorer internal
monitoring of performance.

[Studies of whether schizophrenic subjects process empathy and altruism and

evaluate other-regarding responses in the same way as those not afflicted
could be done using fMRI. Autism sufferers and how their social attachment
deficits effect their functional neuroimaging and spectroscopy results under
conditions of empathy etc. could also be examined and provide insights into
abnormal, normal and extraordinary processes. Affective disorders and their
effects should also be studied using various components of the matrix.]

5.5 Dehaene S, Changeux JP. Reward-dependent learning in neuronal networks

for planning and decision making. The authors present a model of evluation

22
 and decision-making in PFC circuitry based on an elementary reward
mechanism involving the dopamine (DA) brain motivation circuitry.
Mesocorticolimbic DA exerts a global modulatory action on prefrontal
synaptic efficacies. Reward signals function as effective selection signals
that either maintain or suppress currently active prefrontal representations and
working memory as a function of their current adequacy. Neuronal network
computer simulations can be made of this variation-selection model that
successfully account for the main features of several PFC integrity
neuropsychological tasks.

[Raclopride DA receptor displacement studies using PET could be used to

study the DA brain reward mechanisms involved in decisions to love.]

5.6 Biederman J, Hirshfeld-Becker DR, Rosenbaum JF, Herot C, Friedman D,

Snidman N, Kagan J, Faraone SV. Further evidence of association between
behavioral inhibition and social anxiety in children. Am J Psychiatry 2001;
158: 1673-1679. Behavioral inhibition was determined through standardized
interviews in 129 children of parents with both panic disorder (PD) and major
depression (MDD); 22 children of parents with PD; 49 children of parents
with MDD; and 84 control children. Social anxiety disorder is more common
in children with behavioral inhibition. Noninhibited children were more
likely to have disruptive behavior disorders.

[Behavioral inhibition or non-inhibition should be looked at as a

developmental variable in regard to the capacity to be empathic, altruistic and
loving.]

5.7 Greene JD, Sommerville RB, Nystom LE, Darley JM, Cohen JD. An fMRI
investigation of emotional engagement in moral judgement. Science 2001;
293: 2105 The authors hypothesized that the crucial difference between the
moral processing of the trolley dilemma and the footbridge dilemma lies in
the latter’s tendency to engage people’s emotions in a more connected way
than the former does. Thus it is more taxing emotionally to push someone to
his death than to hit a switch that will cause a trolley to produce similar
consequences. These differences in emotional engagement affect people’s
judgements. They went on to create 60 moral scenarios that were divided into
moral and non-moral categories and the moral scenarios were further divided
into moral-personal (footbridge-like) and moral –impersonal (trolley-like).
They did fMRI on 9 normal subjects and found that areas of the brain (medial
frontal, cingulated and angular gyrus) thought to mediate emotions became
more active in the moral-personal conditions.

[Protocols can be established to uncover the relationships between moral-

personal-altruistic and moral-personal-selfish cognitive/emotional decision-
making dilemmas in the area of the brain we call the limbic cortex. The
effects of religious upbringing and spiritual beliefs could easily be tracked.]

23
5.8 Lorberbaum JP, Newman JD, DubnoJR, Horwitz AR, Nahas Z, Teneback
CC, Bloomer CW, Bohning DE, Vincent D, Johnson MR, Emmanuel N,
Brawman-Mintzer O, Book SW, Lydiard RB, Ballenger JC, George MS.
Feasibility of using fMRI to study mothers responding to infant cries. 7
subjects were scanned and 4 had data suitable for analysis. The ACA and the
right medial orbitofrontal cortex showed significantly elevated activity with
the recorded infant cries as compared to white noise.

[Need more study on the developmental effects of the mother –infant dyad on
the construction of the infant brain but also on the neuronal dynamics in
certain regions of the mother’s brain along with the consequences for
unlimited love capacity and behavior.]

5.9 Uvnas-Moberg K. Oxytocin may mediate the benefits of positive social

interaction and emotions. Psychoneuroendocrinology 1998; 23:819-835.
There are many articles from the Karolinska Institute documenting the anti-
stress calming and growth effects (decreased BP, increased withdrawal
latency to tail flick, decreased cortisol, increased insulin and increased CCK),
of the neuropeptide, oxytocin, which is known to initiate affiliation in
mammals (Insel).

[Oxytocin-related affiliation behavior and propensity to develop empathy and

altruism should be creatively investigated in animal and human models.
Vasopressin, endogenous opioids (Panksepp) and perhaps opiates (the s-
tetrahyropapaveroline alkaloid has been isolated in human brain by Sango et
al, Neurosci Lett 2000; 283: 224-226; Stefano et al. Endogenous morphine.
TINS 2000; 23: 429-435.) are also compounds of strong interest with regard
to reward and love]

5.10 Stefano GB, Fricchione GL, Slingsby BT, Benson H. The placebo effect and
relaxation response: neural processes and their coupling to constitutive nitric
oxide (cNO). Brain Res Rev 2001; 35: 1-19. An hypothesis is advanced based
on research on norepinephrine (NE) processes and control via cNO, that cNO
is an antibiosenescent gaseous neurotransmitter with modulating allostatic
effects at the level of the brain, immune and vascular systems. When cNO
mechanisms prevail, as opposed to inducible NO mechanisms, relaxation
favoring belief in the future ensues and has a saludogenic effect which might
account for the placebo response. Non-noxious attachment oriented stimuli
may bolster the cNO effect through central mechanisms. This may occur
through the auspices of oxytocin in the hypothalamus, which stimulates NE
which then stimulates nitroxidergic neurons to produce cNO.

[NO mechanics can be studied using an amperometric probe in human

subjects before and after altruistic love choices. It may also be of interest to

24
 see if religious believers have baseline elevated cNO levels indicating a
favorable internal environment to make loving choices.]

5.11Lazar SW, Bush G, Gollub RL, Fricchione GL, Khalsa G, Benson H.

Functional brain mapping of the relaxation response and meditation.
Neuroreport 2000; 11: 1581-1585; Newberg A, Alavi A, Baime M,
Pourdehnad M, Santanna J, d’Aquili D. The measurement of regional CBF
during a complex cognitive task of meditation: a preliminary SPECT study.
Psychiatry Res 2001; 10: 113-122. Experienced meditators were found in
these 2 studies to activate the ACA and frontal regions involved in focused
attention and also areas of the brain reward circuitry.

[Future studies of meditation might focus on the potential for activation of

these regions to facilitate other-regarding love response selections even in
high conflict/low control settings that might correspond to what we consider
“unlimited love”.]

5.12 Jones NA, Field T, Davalos M. Right frontal EEG asymmetry and lack
of empathy in preschool children of depressed mothers. Preschool children of
depressed and nondepressed mothers were studies in terms of EEG and
empathic reactions to emotion-producing stimuli. Children of depressed
mothers showed right frontal EEG asymmetry which c/w negative affect and
showed less empathy in response to a crying infant as well as to their own
mother’s simulated distress. They also spent more time asking for help and
were slower in completing a teaching task with their moms while their
depressed moms showed less approval and spent less time with them.

[The effects of postpartum depression and maternal depression during

childhood on the abilities of children to develop empathy and altruism should
be studied and EEGs can be helpful tools.]

Question 6

What are the evolutionary constraints on the human development of other-

regarding love?

Significance: Theories such as Hamilton’s theory of kin selection, which suggests

that individuals should show less aggression and more altruism towards closer kin, and
other factors such as limited population dispersal with varying effects on altruist to non-
altruist ratios and on the degree of competition between relatives, need to be taken into
account when considering the vectors that affect the human development of altruistic
love, even if one postulates a qualitative, emergent change in those blessed with the
capacity to love in an unlimited manner.

Key Research Studies:

25
6.1 Chen S, Lee-Chai AY, Bargh JA. Relationship orientation as a moderator of the
effects of social power. J Pers Soc Psychol 2001; 80: 173-187. Individuals were
dichotomized to a communal vs. exchange relationship orientation. The
hypothesis was that communals associate power with social responsibility goals
while exchangers link power with self-interest goals. Power was primed
unobtrusively using semantic cuing in Study 1 and using naturally occurring,
environmental cues in Studies 2 and 3.Across studies, communals responded in
socially responsible ways, while exchangers were self-interested responders.

[Research might take a group of relatives and separate them into communals and
exchangers and investigate presumed evolutionary contributers and relationship
orientations to power instigated choices.]

6.2 Korchmaros JD, Kenny DA. Emotional closeness as a mediator of the effect of
genetic relatedness on altruism. Psychol Sci 2001; 12: 262-265. Ultimate and
proximate causes of altruism were studied, especially the role of emotional
closeness as a mediator of the effect of genetic relatedness. College students were
asked to choose which of their family members they would most likely provide
with life-saving assistance. As predicted emotional closeness was an important
proximal cause of altruism that partially mediates the effect of genetic relatedness
on the willingness to act altruistically.

[This relates to the importance of emotion in evaluating moral dilemmas. There is

an emotional bonding modification of evolutionarily based propensities in
humans that if extrapolated might account for the ability to transcend genetic
relatedness altogether. The role of religiously inspired bonds to “our fellow man”
might be studied in this regard.]

6.3 Mikulincer M, Shaver PR. Attachment theory and intergroup bias: evidence that
priming the secure base schema attenuates negative reactions to out-groups. J
Pers Soc Psychol 2001; 81: 97-115. The authors performed 5 studies to examine
the effects of priming the secure base schema on intergroup bias. Studies 1-2 also
examined the effects of dispositional attachment style, while Studies 2-5
examined a mood interpretation. Study 3 looked specifically at the mediating role
of threat appraisal while Studies 4-5 focused on the effects of secure base
priming while inducing a threat to self-esteem or cultural worldview. Secure
base priming, which was not dependent on attachment style and not explained by
mood induction, was most powerful at lessening negative evaluative reactions
toward outgroups. The effects of secure base priming were mediated by threat
appraisal and occurred even under conditions of threatened self-esteem and
cultural worldview. The authors state that attachment theory has an important
contribution to make to our understanding of ingroup-outgroup dynamics.

[The degree of effect penetration of individual secure base attachment on the

capacity to expand the circle of inclusion in an ever-widening group considered
worthy of altruistic love, may be the evolutionary rate limiting step of the entire

26
 human project. Studies designed to prime the secure base attachment of
individuals to see whether this can truly reduce intergroup bias are essential to our
study of the human development of unlimited love.]

6.4 Kurzban R, Tooby J, Cosmides L. Can race be erased? Coalitional computation

and social categorization. PNAS 2001; 98: 15387-15392. Experiments are
reported that suggest that categorizing individuals by race is not inevitable;
encoding by race is instead a reversible byproduct or side effect of
neurocognitive computational machinery that evolved to detect coalitional
alliances. Coalitional alliance recognition is highly normalized. By changing the
cues of coalitional affiliation, race drops down as a significant categorizing
device. In this study subjects were found to mix up recalled statements as coming
from one person or another on interracial teams of basketball players more on the
basis of which team they belonged to than on the basis of which race they
belonged to. “These results suggest that racism may be a volatile and eradicable
construct that persists only so long as it is actively maintained through being
linked to parallel systems of social alliance”.

[This study suggests that in addition to priming secure base attachment, changing
the cues of coalitional alliance may be a way to expand the ingroup and reduce
intergroup bias. Studies combing the 2 approaches would be most interesting.]

Question 7

What can be learned about the human development of unlimited love from
“religious altruism” in the medical context?

Significance: Clinicians performing psychiatric assessments of potential living-

unrelated organ donors (LURDs) must evaluate the motivations behind the act, which
strictly in terms of its physiological implications is entirely altruistic. A subset of these
individuals may offer us a group to study in terms of the determinants of healthy altruistic
love. Patient volunteers and other volunteers in the medical setting can have powerful
other–regarding effects that may also be of interest.

Key Research Studies:

7.1 Dixon DJ, Abbey SE. Religious altruism and organ donation. Psychosomatics
2000; 41: 407-411. The authors describe clinical cases to illustrate that oftentimes
LURDs conceptualize their offers exclusively in terms of their religious beliefs
and not in terms of kinship or emotional intimacy with the intended recipients.
The negative reactions of some doctors to the offers reveal the readiness with
which religious beliefs can be pathologized. It also reflects how a restrictively
biological understanding of relationships can unduly restrict the clinical
understanding of healthy altruism. See also: Neumann ME. “Stranger
donation”—the next level of altruism? Nephrol News Issues 2000; 14: S13-s14.

27
 [More study should be made of LURDs and the religious altruism of many of
them. Any of the matrix variables can be applied in this research in an attempt to
better understand how their capacity to love in such a way develops and comes to
pass in the offer of donation.]

7.2 Sullivan GB, Sullivan MJ. Promoting wellness in cardiac rehabilitation:

exploring the role of altruism. J Cardiovasc Nurs 1997; 11: 43-52. The authors
propose, based on research implicating social isolation in increasing the risk of
cardiac events, that the use of volunteer, patient driven support groups may
provide an effective approach to improve social support and enhance “altruism”
in patients with coronary disease. They suggest that “altruistic behavior” may
benefit the giver and the recipient of the care and urge more study.

[This population could be studied to see what factors prompt an increase in

altruistic behavior after experiencing the suffering of illness and what effects this
increase may have.]

7.3 Seelig BJ, Dobelle WH. Altruism and the volunteer: psychological benefits
from participating as a research subject. ASAIO J 2001; 47: 3-5. The authors
submit that superficially altruistic behavior in research subject volunteers serves
multiple psychological functions. In interviews with subjects who had volunteered
20 years earlier they found lasting self-esteem.

[Psychological benefits from “altruistic” behaviors can be examined in these

studies.]

Question 8

What do we know about how we can teach altruistic behavior and empathy?

Significance: If we are not to be fatalistic about the capacity to develop unlimited

love (you either have it or you don’t) we need to learn more about the best
strategies on how to build it in individuals. One way to try to do this is to perhaps
teach empathy and altruism as prerequisites for unlimited love.

Key Research Studies:

8.1 Hatcher SL, Nadeau MS, Walsh LK, Reynolds M, Galea J, Marz K. The
teaching of empathy for high school and college students: testing Rogerian
methods with the Interpersonal Reactivity Index (IRI). Adolescence1994; 29:
961-974. 104 H.S. and college students were given the IRI (which measures
cognitive and emotional components of empathy) before and after a standard
course of Rogerian-based peer facilitation skills training. Greater developmental
readiness for learning empathic communication was statistically increased in the

28
college sample. College females began with higher empathy scores but both
genders were equally teachable.

[Training in empathy can be combined with measurement of several of the matrix

parameters before and after.]

8.2 Coulehan J, Williams PC. Vanquishing virtue: the impact of medical

education. Acad Med 2001; 76: 598-605. The authors describe a group of medical
students that is “immunized” against detachment, self-interest and objectivity in
favor of doctoring empathy, compassion and altruism. The immunization factors
include personal characteristics (gender, belief system, non-medical
commitments) and medical school features (family medicine, communication
skills training, medical ethics, humanities and social issues in medicine). To be
effective these latter features must be prominent and well integrated into the
curriculum and culture.

[Research might focus on a longitudinal survey of empathy and altruism attitudes

and capacities across the medical education experience]

8.3 Walther E, Muller D, Schott O. Automatic social behavior: how does

activation of the concepts of egoism and altruism influence helping behavior? Z
Exp Psychol 2001; 48: 248-257. Altruistic, egoistic and neutral prompts were
used in advance of activating helping behaviors. The altruistic and neutral
prompts showed no difference but the egoistical prompt led participants to a
higher latency and less help response more often than participants in the other 2
conditions.

[The power of media and other messages in the prompting of altruistic vs selfish
behaviors would be an interesting area to study]

8.4 Dunn J. Sibling influences on childhood development. J Child Psychol

Psychiatry 1988; 29: 119-127. Siblings play a major role in the development of
aggressive behavior, in a child’s style of conflict behavior and in cooperative
fantasy play. Family factors are closely involved in the quality of sibling
relationships.

[Sibling relationships should be examined for clues to the development of

capacity to love]

8.5 Poresky RH, Hendrix C. Differential effects of pet presence and pet bonding
on young children. Psychol Rep 1990; 67: 51-54. Mothers rated their young
children’s companion pet bond and social competence. A researcher assessed the
children’s empathy, cooperation and intelligence during home visits. Children’s
pet bonds were c/w social competency and empathy scores.

29
 [Loving relationship with a companion animal is another factor that may foster
the capacity for loving social attachment and this could be further examined.]

Question 9

Is there a genetics of love that we need to pay attention to?

Significance: There are certainly genetic endowment considerations when we

come to the capacity to develop empathy, altruism and unlimited love. These will
eventually need to be studied, but the field is likely to be among the most complex given
the degree of certainty that these attributes are multi-sited genotypically and multi-
determined phenotypically. Nevertheless there are some hints out there.

Key Research Studies:

9.1 Pitkow LJ, Sharer CA, Ren X, Insel TR, Terwilliger EF, Young LJ.
Facilitation of affiliation and pair-bond formation by vasopressin receptor
gene transfer into the ventral forebrain of a monogamous vole. J Neurosci.
2001; 21: 7392-7396. Researchers used an adenovirus vector to deliver the
gene for the vasopressin receptor (V1aR) into the ventral pallidum of the
male prairie vole brain. The gene caused the voles to overexpress V1aR,
thereby increasing the density of vasopressin binding to the receptor. This
intervention increased measures of vole pair bonding such as time spent in
female partner’s cage. This is the first study to demonstrate that complex
social behaviors, such as social attachment, can be increased by viral vector
gene transfer.

[Other mammalian social attachment behaviors that more closely model

empathy or altruism may be used to study gene effects.]

9.2 Olson JM, Vernan PA, Harris JA, Jang KL. The heritability of attitudes: a
study of twins. J Pers Soc Psychol. 2001; 80:845-860. The authors replicate
earlier claims that part of the variance in indices of social attitudes is
secondary to genetic loading. They examine a survey of 195 pairs of MZ
twins and 141 pairs of same sex DZ twins looking at the genetic basis of
individual differences in attitudes. Six of the 30 attitudes looked at in a
principal components analysis showed significant heritability coefficients.
For example there is heritability of athletic prowess; this leads to a genetic
predisposition to athletic success and furthermore, mediated by athletic
success, a positive social attitude toward athletics then develops.

[Could this be the same to some degree for heritability of the capacity to love,
followed by success in loving and a positive attitude toward unlimited love?]

30
Question 10

How powerful are the effects of religious experience, belief and/or behavior on the
capacity to love in the way that Millard Fuller might call “practical Christianity.”?

Significance: The true message of all the world’s great religions is to love one
another. In Christianity it comes down to us as part of the great commandment—to love
one another as one loves oneself. This message is fueled by our spiritual belief in a God
who loves us and is symbolized in the rituals of religious behaviors. Religious experience
(and some might qualify this as needing to be “authentic”) of awe and oneness and
heightened perception of the spiritual may be among the most powerful motivators of
extraordinary love. It should be noted here that certain neurological conditions, in
particular temporal lobe epilepsy, are known to stimulate religious experiences, which
underscores the need to address the question of authenticity. Nevertheless there is the
anecdotal belief that this all enhances our capacity to be altruistic and loving, culminating
in “greater love than this no man has but to give his life for another.” But is there more
than anecdotal evidence for this?

Key Research Studies:

10.1 Hays JC, Meador KG, Branch PS, George LK. The Spiritual History Scale in
four dimensions (SHS-4): validity and reliability. Gerontologist 2001; 41: 239-
249. 30 elderly volunteers were studied with semi-structured interviews followed
by structured interviews of a random sample of 157 elderly subjects. Principle
components analysis of the SHS-4 suggested 4 factors with favorable
psychometrics. These were “God Helped” in health-impaired (health related
behaviors associated); Lifetime Religious Social Support (good social support and
health related behaviors); Cost of Religiousness (predicted depressive symptoms
and poor social support); and Family Religiousness (not related to late-life
health).

[The SHS-4 could be used to stratify an elderly cohort and then search for
correlations with empathy, altruism and other-regarding love.]

10.2 Krause N, Ingersoll-Dayton B, Liang J, Sugisawa H. Religion, social

support, and health among the Japanese elderly. J Health Soc Behav 1999; 40:
405-421. The researchers analysed the relationships among religion, support
giving and health, with data on 2,153 elderly people who were interviewed in
1996. Greater involvement in religion was associated for men only, with
providing help to others more often. Subjects who provided assistance to others
more often rated their health more favorably.

[More studies documenting the relationship between religion and the human
development of self-giving behavior are needed]

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 10.3 Saver JL, Rabin J. The neural substrates of religious experience. J
Neuropsychiatry Clin Neurosci 1997; 10:475-476. The authors propose a “limbic
marker hypothesis” for religious numinous experience based on clinical and
laboratory findings in temporal lobe epilepsy, near-death experiences and
hallucinogen use. The temporolimbic region of the brain tags certain internal or
external sensory stimuli as depersonalized, derealized, vitally important,
connected and harmonious, joyous etc. This then thought to activate
comprehension of these experiences within a context of religious meaning.

Question 11

Do conditions of “brokenness” free us from inauthentic or routinized existence and

provoke a response of other regarding love?

Significance: There is a literature in psychiatry and psychoanalysis (Franz

Alexander, Heinz Kohut) that describes the power of the “corrective emotional
experience”, encountered by a wounded individual during the course of psychotherapy
with a caring therapist, to heal past trauma and allow the individual in turn to become
more caring. There is also a literature in existential philosophy and existential psychiatry
that talks about man’s essential “brokenness” –a condition of inevitable struggle,
suffering, guilt and death. (Karl Jaspers) Our “brokenness” is revealed in these “limit
conditions” and leads to the “limit questions” that all redound to whether life is
meaningful (Viktor Frankl). But meaning for the human has developed in a social context
due to the survival strategy of social attachment that has evolved. How then do we remain
as individuals in attachment in the face of these ever-present limit conditions?
In the midst of this pain of existence, there is a message in code or cipher as
Jaspers would call it that speaks to us of the deep reservoir of spirituality and religion that
has evolved and seemingly is permanently present in the human. From this reservoir we
can draw strength, when broken, to mobilize and approach toward a Creative Presence.
The existential threats presented by the limit conditions of our “brokenness” can be met
by the solution of attachment to God who completes us. The corrective emotional
experiences we benefit from in our transitional relationships with our caregivers, help us
deal with our limits and our pasts and perhaps serve as ciphers of our deepest relationship
with God. The practical significance of this may be that there are concrete changes in
loving attitude and behavior in recipients of that transitional love.

Key Research Studies:

11.1 Kriebel A, Tress W. Love and partnership in adulthood: a continuation or
correction of early childhood experiences? A review of theoretical concepts. Z
Psychosom Med Psychoanal 1987; 33: 276-293. The authors address the question
of whether or not and if so to what extent a mature, adult ability to love depends
on relevant early experience, or whether it functions as a corrective to unfavorable
emotional experience in early childhood. The empirical studies reviewed point to
a possible involvement of corrective and compensatory mechanisms for
unfavorable early experiences of a medium degree of severity. By the same

32
 token, warm affection from parents based on needs during the first years of life
provides a basis for the adult’s ability to love and form partnerships.

[Studies may be designed to measure empathy, altruism and other-regarding love

in subjects stratified according to their Parental Bonding Inventory scores. A
study of the effects of a loving adult caregiving relationship on these measures
could also be designed].

11.2 Khantzian EJ. Reflections on group treatments as corrective experiences for

addictive vulnerability. Int J Group Psychother 2001; 51: 11-20. Group therapy is
presented as a unique corrective emotional experience for those with addictive
disorders who have problems with self-regulation and the psychological suffering
that ensues.

[Measurements of empathy, altruism and love may be taken before and after
group therapy in those with addictive disorders. The same study can be done with
those undergoing faith-based approaches to care.]

11.3 Spinner DA. The evolution of culture and cohesion in the group treatment of
ego impaired children. Int J Group Psychother 1992; 369-381. The author looks
at the effect of fostering an indigenous group culture in children who have volatile
affects and impulses. A sense of normality and commonality with the
development of a structure and language for affiliation, play and mutual
identification can create a holding environment to begin a dialogue of
communication that is essential for creating a corrective emotional experience.

III. Annotated Bibliography

1. Bowlby J. Attachment and loss. Vol.1 Attachment, 1982 (revised); Vol.2 Separation,
1973; Vol.3 Loss, 1980.Basic Books, NY.
Using an approach informed by ethology, biology, and control theory as well as
psychology, Bowlby arrived as several main propositions. First of all, emotionally
significant attachment bonds between individuals serve a basic survival function and
therefore have a primary status. Second, an understanding of these attachment behaviors
can be arrived at using cybernetic theory wherein each partner's CNS contains a system
designed to maintain proximity or accessibility of one to the other. Third, working
models of self and other and interaction patterns develop over time in each partner's mind
allowing for efficient operation of the relationship. Fourth, instead of developmental
stages to which one becomes fixated or to which one regresses, Bowlby favored a theory
of developmental flow pathways.
The emotional bonds that form between parent and child serve several functions
including care seeking and caregiving. This human capacity to seek and secure comfort
and solace from attachment is not to be seen as regressive dependency but rather as an

33
important characteristic of adaptive character behavior and reflective of mental health. At
times the individual in a mature bond will be care seeking while at other times he will be
caregiving. Man's "environment of evolutionary adaptiveness is one of secure base
attachment." "When individuals of any age are feeling secure they are likely to explore
away from their attachment figure."
Bowlby writes: "The key hypothesis is that variations in the way these bonds develop
and become organized during the infancy and childhood of different individuals are
major determinants of whether a person grows up to be mentally healthy."
The origins of the human capacity to love can be uncovered in security of the
attachment bond.

2. Winnicott DW. Human nature. Schocken Books, 1988.

In Winnicott's concept of transitional phenomena a breakthrough was made in the

understanding of how internal psychological structure interrelates to the external world.
He examines "the transition between the child's infantile solipsistic world of self-
absorption and the emerging capacity to relate to objects," in the words of psychoanalyst,
WW Meissner.

Winnicott himself writes: "How important then are these early transitional objects and
techniques! Their importance is reflected in their persistence, even crude persistence over
the years. Out of these transitional phenomena develop much of what we variously allow
and greatly value under the headings of religion and art and also the little madnesses
which are legitimate at the moment, according to the prevailing cultural pattern."
Love is encountered in the re-attachment offered us in our transitional relationships.

3. Horton PC. Solace. The missing dimension in psychiatry. Yale University Press, 1981.
Solace serves as "the driving force behind transitional activities throughout life." It has
its wellspring in the connection between the maternal primary process presence and the
latent oceanic experience. Horton contends that the penultimate goal of transitional
relatedness throughout the life cycle is the re-experiencing of the maternal primary
process presence. And the ultimate goal is the Holy Grail of that oceanic experience of
oneness (not aloneness but attachment) itself. In this context "transitional solace is
qualitatively separable from and more psychologically basic than all other pleasures and
joys."

Caregiving love takes place in the transitional space between threatened separation
and attachment hope. In self-giving love the object of it experiences the solace of
attachment, which gets reflected back to the giver. Illness of all types represents a
separation threat and calls for the self-giving love of psychiatrists and all medical
caregivers.

34
4. Vaillant GE. Adaptation to life. (New Edition). Harvard University Press, 1995.

Vaillant is the Director of the longest running study of adult development-The Grant
Study of Adult Development. This study examines the use of what are called "ego
mechanisms of defense." These are the mental processes we use to deal with the
psychological conflicts of our inner life when instincts, the external world, important
objects and our superegos collide. Through the employment of questionnaires,
interviews, and other methods of assessment the Grant Study investigators looked at the
effectiveness of mature vs immature defenses used by the 98 Harvard College 1939-42
sophomores in the study over the 50 years of follow-up. The author concludes that mental
health is a way of reacting to problems, not an absence of them. Mature defenses are
found to be used by those men who were healthiest both physically and physically.

Among the most mature defenses is altruism, which seems to be an adaptive strategy
to be cultivated.

5. MacLean PD. The triune brain in evolution. Role in paleocerebral function. Plenum
Press, NY,1990.

The importance of the relationship between separation and attachment in evolution is

perhaps best supported in light of the evolution of the brain from reptile to mammal-like
reptile (therapsid) to mammal. (Indeed scalable architecture studies in mammalian brains
reveal that cerebrotypes have evolved through directed selection pressure [Clark DA,
Mitra PP, Wang SS. Scalable architecture in mammalian brains. Nature 2001;411:189-
193.]). Mammals as opposed to reptiles on the whole have a social attachment survival
strategy. MacLean reveals why this is so, based on neuroanatomy and neurophysiology.
Important in this discussion is what MacLean calls the "mammalian behavioral triad."
This triad consists of: 1. Maternal nursing and care; 2. the separation cry of the infant for
the mother; 3. play among conspecifics.
Whereas reptiles and mammals share prototypical parts of the brain including brain
stem, basal ganglia, rudimentary amygdala, hippocampus, and septum, only mammals
have an advanced anterior cingulated cortex, insula and prefrontal cortex.
While much controversy persists in the field of brain evolution (others to read
include Ann Butler and Harvey Karten) MacLean's work is notable for it's combination of
data and creativity in addressing the question of how attachment is mediated in mammal,
primate and human brains with importance for our understanding of empathy, altruism
and love.

6. Clark WR and Grunstein M. Are we hardwired? Oxford University Press, Oxford,

2000.

35
 Using studies of identical twins reared apart, the authors report their impression that
approximately 50% of human behavior has a genetic basis. They focus on individual
behavioral traits like aggression (study of 300 MZ and DZ twin pairs reared apart showed
a significant heritability of 47% for direct physical assault), mental function, eating
disorders, sexual preference, alcoholism and drug abuse. They stress that very few
elements of behavior depend upon a single gene. It is the gene complex, often across
chromosomes, along with protein foldings, that prompts most of our heredity based
actions. Genes and environment cooperate. Heredity affects how we appraise our
surroundings. Our environmental appraisals in turn alter the structure of the brain.
The individual human development of unlimited love is presumably the product of
gene-protein-environment interaction just as human species development is the product
of gene-culture evolution. A thorough understanding of the capacity for unlimited love
will require genetic studies on this aspect of human behavior.

7. Damasio A. Descartes'error. Emotion, reason and the human brain. Grosset/Putnam,

NY, 1994.
Damasio proposes that the elicitation of innate primary emotions require the
amygdala and the anterior cingulated cortex as primary sites. These emotions can become
responsible for certain internal brain responses, muscular movements and visceral
responses brought about by the autonomic nervous system and hypothalamic changes that
ensue. It will be these bodily responses stimulated through emotional memory in concert
with the brain's responses to "emotional memory" that will form what he terms "somatic
markers"-essential signals to aid the conscious reasoning apparatus in attaining a
favorable pleasurable outcome (positive attachment).
Somatic markers associated with loving of others may facilitate and reinforce the
decision to approach others in a self-giving way. This may be a fertile area to study.

8. Llinas R and Churchland PS (eds). The mind-brain continuum: sensory processes. MIT
Press, Cambridge, 1996.
The brain can be viewed as a "reality emulator". It can embed a "type of reality
emulation that evolved to specify internally the salient aspects of the surrounding world."
(Llinas and Pare, 3).This is necessary to effect any directed movement, for without this
sensory analysis there would be no predictive image of an event. This premotor template
is a prerequisite to produce purposeful behavior and to eventually produce consciousness.
In this regard, the CNS is a self activated process whose intrinsic order is the brain's core
activity. Sensory experience and motoric effects modify this core activity. Emotions can
be thought of as "examples of internally generated intrinsic events that are clearly
premotor templates in primitive forms." (Llinas and Pare, 5.) The nervous system thus
evolved as a neuronal network of complexified, segregated and integrated circuits
(Alexander basal ganglia-thalamocortical circuits) to mediate sensory- motor relations
initially in simple reflexive ways. Cognition is not a learned property of the brain but

36
rather an a priori property developed over eons to perform an analyzer function in the
complexified sensori-motor analyzer-effector organ we call the brain.

Certain realities and the beliefs that accompany them will be nurtured in the
important transitional relationships of childhood with implications for the brain as reality
emulator and for future premotor templating. Certain attachment experiences may
promote the capacity to form premotor templates of other regarding love.

9. Mayr E. This is biology. The science of the living world. Belknap Press, Harvard
University, Cambridge,1997.
Mayr explains that, while individual selection pressures gave rise to "inclusive
fitness" and "reciprocal altruism," it was selection pressure on human cultural groups that
gave rise to "genuine altruism." Enlarging of the group in the face of challenge was
selected for. This required extending concern for well-being to non-relatives. Cultural
norms for behavior towards non-relatives followed, counteracting the selfish tendencies
of individuals in the group. Thus the constraints of altruism directly benefit the group as a
whole. But for each individual human with the power of conscious reasoning, a decision
must be made. Human altruistic behavior can thus involve the deliberate choice of ethical
agape love over selfish behavior rather than relying on instinctual inclusive fitness. "This
adaptive shift from an instinctive altruism based on inclusive fitness to a group ethics
based on decision-making was perhaps the most important step in humanization." (Mayr)
The decision to love in each individual has its antecedents in the evolutionary
struggle to meet separation challenges with attachment solutions. This is impacted upon
by gene-culture evolution, which then provides feed-back on individual decisionmaking.

10. Williams DD. The spirit and the forms of love. Harper and Row, NY, 1968.
The late process theologian Daniel Day Williams argues that self-love, i.e., self-
affirming love, is nothing more than a desire to belong. Self-hood at a deep level is a
desire to 'feel at home in the world' and so to be in community; thus we have a paradox
that self-hood (having our own being) is essentially an offer of communication. This
realization suggests that love is in essence mutuality. Self-affirming love and self-giving
love are harmonious. One individuates in community.
Williams writes: " I use the term agape to refer to the self-giving and forgiving love
which God has decisively expressed in the world in his redemptive activity in Jesus. I
mean by the human loves all our experiences of organic feeling and sympathetic
attachment for things and persons in the world." (Williams, 205)
In self-love and self-assertion there is always "both the pole of autonomy, the
affirmation of self-integrity and independence, and the pole of symbiosis, which requires
conformity and relatedness to the other. Both autonomy and symbiosis require

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communication and response....Belonging involves communication and no self can exist
without some fulfillment of this fundamental need. (Williams, 206)

And with this developmental understanding, "we now see human loves in a new
light. Agape is not another love, which is added to the others. Neither is it their
contradiction. It is the love which underlies all others, leads them towards the discovery
of their limits, and releases a new possibility in the self which is created for communion."
(Williams, 210)
In this understanding, one can envision the creative power of God and of religious
belief in building the human capacity to love.

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